Session Title: Metabolic and Crystal Arthropathies: Mechanisms of Disease
Session Type: Abstract Submissions (ACR)
Hyperuricemia is particularly common in patients with chronic kidney disease (CKD). Its role, however, as a risk factor for renal outcomes of CKD is debated. This aim of study was to evaluate long-term effect of serum uric acid (SUA) level on progression of CKD in gout patients with uric acid lowering treatment.
All patients who had a first visit for gout with CKD at Samsung Medical Center between 1995 and 2003, and follow-up until December 2012 or expired during follow-up period were included and retrospective analyzed. CKD was defined as an estimated glomerular filtration rate (GFR) of < 60 mL/min/1.73m2 via MDRD Study equation more than 3 months. All serum creatinine and matched SUA taken during follow-up period were analyzed by using Mixed effect model to determine the effect of SUA level on renal outcome.
One-hundred eleven gout patients with CKD were observed. The mean age of the patients at diagnosis of gout was 51.3 and mean follow-up duration was 13 years. Baseline eGFR and serum creatinine were 47.7 mL/min/1.73m2 and 1.62 mg/dL, respectively. Maintaining the SUA below 6 mg/dL showed protective effect on serum creatinine and eGFR compared with SUA more than 6 mg/dL (p < 0.0001 and p = 0.02, respectively). Mixed effect model demonstrated that the protective effect on renal outcome with maintaining the SUA below 6 mg/dL was statistically significant after adjusting baseline age, follow-up time, hypertension, diabetes mellitus, history of cardiovascular disease, obesity, and intrinsic renal disease (p < 0.0001). Hypertension, diabetes mellitus and follow-up time were independently associated with progression of chronic kidney disease (p < 0.001, p < 0.001 and p < 0.001, respectively). In particular, for every 1 mg/dL increase of the SUA, serum creatinine revealed to be increased 0.02 mg/dL when the SUA is more than 6 mg/dL (p < 0.0001).
Our long term follow-up data demonstrated the SUA level was associated with progression of CKD in gout patients. Maintaining of SUA level below 6 mg/dL would be essential to protect renal function in gout patients with CKD.
Y. H. Lim,
E. J. Park,
H. S. Cha,
E. M. Koh,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/serum-uric-acid-as-an-independent-risk-factor-on-progression-of-chronic-kidney-disease-in-gout-patients-with-uric-acid-lowering-agent/